[Worldwide experience and recent trends in gene therapy of ischaemic diseases]

Fifteen odd years have passed since the first application of a gene-therapeutic modality in clinical practice for treatment of lower-limb chronic ischaemia. Over this time, vast experience has been gained worldwide, with not less than one thousand patients treated by gene-based therapies, thus making it possible to generalise the published findings of these clinical trials. Resulting from such an analysis, it should be recognized that the least dangerous gene therapeutic modalities available so far are plasmid ones, with the most efficient being those containing the gene of vascular endothelial growth factor VEGF(165). The most convincing results were obtained while treating chronic ischemia of the lower extremities, whereas gene-based therapy used for treatment of coronary artery disease failed to have yielded, as of yet, clear cut positive results.